Baptist Leaders Retreat 2019: Registration
This is an online registration form for the "Baptist Leaders Retreat" on 22-24 April 2019 at Swiss-Belhotel Harbour Bay in Batam, Indonesia, organized by the Pastoral Development Institute (PDI) and the Singapore Baptist Convention (SBC).

Alternatively, you may download and fill-in a hard copy of the form via the link below:
https://tinyurl.com/ya7hpkyh

By filling in the registration form (online or printed) and submitting it to us, you consent to sharing your personal information with the Singapore Baptist Convention for the purpose of follow-up for the above stated event, and for any future related events, in accordance with the Personal Data Protection Act (PDPA).

For more information, please contact dani@baptistconvention.org.sg or call the Convention office at (65) 6253 8004.

Deadline to register by 15 March 2019.

Email address *
(1a) Full Name (as in Passport) *
Your answer
(1b) Title/Honorific
e.g. Rev, Dr, Pastor, Mr, Mrs, Ms, Mdm, etc.
Your answer
(2) Church/Organization/Seminary Affiliation *
Your answer
(3) Contact Number *
Your answer
(4) Emergency Contact *
Please indicate full name and contact number (e.g. Jane Doe 87654321)
Your answer
(5) Date of Birth *
MM
/
DD
/
YYYY
(6) Nationality *
Your answer
(7) Passport Number *
Your answer
(8) Passport Date of Issue *
MM
/
DD
/
YYYY
(9) Passport Date of Expiry *
MM
/
DD
/
YYYY
(10a) Room Type *
(10b) Name of Room-mate [Twin-sharing only]
Please indicate the full name of the person you wish to share a room with. If you have no preference, you may leave this question blank.
Your answer
A copy of your responses will be emailed to the address you provided.
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